OBESITY is defined as excessive fat accumulation in the body, detrimental to health and well-being. Today, it is one of the commonest medical problems in the world and a greater risk factor for many diseases such as hypertension, diabetes, arthritis and cardiovascular effects. It is a complex condition when a person gains excessive body weight due to disturbed energy balance from excessive caloric intake and less physical usage being influenced by various genetic, behavioural and environmental factors. In fact, a healthy weight is the balancing of calories intake through healthy eating habits in order to maintain a healthy weight. Additionally, poor quality of sleep and stress may complicate things worse. In fact, it is difficult to pinpoint one exact cause for being over-weight and to reverse the condition once a person gains weight.
Earlier, the obesity was considered only a problem of rich people, now the trend is fast changing all over the world with progressive economy, lifestyle changes and environmental factors. Since 1980, there is a dramatic increase of obesity in the Middle East and Gulf countries with the highest prevalence of obesity especially in the elderly people. Some medications like anti-depressants, anti-diabetics, steroids and antipsychotic drugs commonly used in common diseases, may cause weight gain. Today, the treatment of obesity costs to the society with increased medical expenses, loss of productivity in the workplace, disability claims and job discrimination. According to a study, approximately $30 billion are being spent in treating obesity in the United States alone each year.
Poverty, low educational level, lack of nutritional knowledge and poor hygienic conditions appears to be linked with unhealthy diet resulting in the development of various diseases and obesity. Since the standards of living continues to rise, weight gain is posing a growing threat to various health issues in all the age groups. Currently, scientists consider that life style changes and a balanced diet with active physical and mental activities can save us from the obesity and vagaries of unhealthy life. Currently various studies indicate that what we eat does not matter, but increase in energy consumption certainly helps in maintaining normal body weight, Moreover, common environmental factors such as inactive life due to absence of recreation areas like parks and play grounds, high-rise buildings with electronic lifts play an important role in the development of obesity. Additionally, there is a modern trend of using drugs for minor ailments such as antidepressants and steroids, that stimulate appetite and retention of extra fluids in the body are responsible for weight gain. Moreover, common health issues like flu, body ache, joint pains and unnecessary usage of drugs without medical consultation, mostly result in mobility limitations and weight gain.
In fact, reducing obesity is one of the most difficult job in our life, particularly in children, adults and low-income countries. WHO has observed that the visceral fat is more common in them, therefore the obesity has become a leading risk factor for various diseases, above the age of 60 years in more developed countries. In the UK, it is 22% in women and 12% amongst the men. Similarly, in Australia where obesity has dramatically arisen from 24% in males to 30% in females. Whereas the prevalence of obese elderly in China being 21.0 % in males and 7.4% in females. Studies from Netherlands show that obesity is present in 18% in men and 20% in women. However, in France it appears to be relatively stable i.e., 6.4 % in males and 6.3–7.0% in females. Whereas in some Gulf and Asian countries, the obesity prevails on the higher side amongst the elderly. Similarly, in Nigeria overweight amongst elderly ranges from 20.3 to 35.1% in general.
Scientifically speaking, the changes in body composition vary for men to women, gaining weight around 55 years of age and losing later in life with the advancing age, due to change in hormonal secretion. Currently, we have observed an increasing trend of’ eating out’, the diet with higher protein and sugary drinks over the traditional home made diet which is simpler and balanced. Studies has shown that people usually lack the nutritional knowledge and suffer from many serious health issues like diabetes, hypertension and reduced physical activity. In fact, we do not consider obesity as an illness but a lifestyle eating disorder. In fact, there are possibly few risk factors during pregnancy like diabetes, high blood pressure in ageing population even miscarriage in repeated pregnancies. Medication with lifestyle modification has a greater effect in reducing obesity. There are many recent drugs used with encouraging results. However, treatments like behavioural therapy and dietary medications combined with increased physical activity is the most effective method of reducing obesity.
A recent study has added some benefit from the use of multivitamin improves the age-related cognitive decline. However, recently the epidemiologists and clinicians have focused their attention towards the health issues in elderly people using weight reducing medications which appear safer and help people feel less hungry and often less interested in food intake. In fact, calorie intake depends on metabolic needs which lead to the initial success of weight reduction. But some people develop obesity despite of physical activity. Scientists believe that genetic pre-disposition may explain some of the variability in response to exercise. —To be continued
—Co-authors Dr Madiha Durrani and Dr Zainab Inam.
